Lisa Andrea Vittorio Emanuele, Mela Alessandro, Miranda Sergio, Alessandri Bonetti Mario, Bottoni Manuela, Intra Mattia, Pagan Eleonora, Bagnardi Vincenzo, Rietjens Mario
Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, 20141 Milan, Italy.
PhD Program in Applied Medical-Surgical Sciences, Department of Surgical Sciences, University of Rome "Tor Vergata", Viale Oxford 81, 00133 Rome, Italy.
J Clin Med. 2024 Oct 21;13(20):6276. doi: 10.3390/jcm13206276.
: The reconstruction of large breasts carries a heightened risk profile. While skin-reducing mastectomy (SRM) techniques facilitate the correction of breast ptosis, they are frequently associated with a high incidence of vascular complications. This study compares two SRM techniques-the horizontal incision and the classic inverted T incision-by examining their clinical and surgical outcomes. : We retrospectively analyzed data from 24 patients (30 breasts) who underwent SRM with immediate prosthetic reconstruction between 2019 and 2023 at the European Institute of Oncology in Milan, Italy. Our comparison focused on breast aesthetic outcome, reconstruction quality, complication rates (early and late), and patient satisfaction, utilizing the BREAST-Q questionnaire to gauge the latter. : Among the 24 patients included in the study, 16 (20 breasts) were treated with the inverted T technique, and 8 (10 breasts) with the horizontal incision approach. A higher overall complication rate was observed with the inverted T technique compared to the horizontal method, with early complications outnumbering late ones. The most common issues were recurrent seroma and skin necrosis leading to implant exposure. Notably, there were no cases of implant infection. Although the horizontal incision technique achieved slightly higher patient satisfaction scores, the difference was not statistically significant. : The inverted T and horizontal incision techniques each have unique benefits and drawbacks. Our findings indicate enhanced patient satisfaction and reduced complication rates with the horizontal incision technique. The selection of the technique should be customized based on the patient's individual risk factors, tissue quality, and preferences.
大乳房的重建具有更高的风险。虽然皮肤缩减乳房切除术（SRM）技术有助于矫正乳房下垂，但它们经常与血管并发症的高发生率相关。本研究通过检查两种SRM技术——水平切口和经典倒T形切口——的临床和手术结果进行比较。
我们回顾性分析了2019年至2023年期间在意大利米兰欧洲肿瘤研究所接受SRM并立即进行假体重建的24例患者（30个乳房）的数据。我们的比较重点是乳房美学效果、重建质量、并发症发生率（早期和晚期）以及患者满意度，使用BREAST-Q问卷来评估后者。
在纳入研究的24例患者中，16例（20个乳房）采用倒T形技术治疗，8例（10个乳房）采用水平切口方法治疗。与水平方法相比，倒T形技术观察到更高的总体并发症发生率，早期并发症多于晚期并发症。最常见的问题是复发性血清肿和皮肤坏死导致植入物暴露。值得注意的是，没有植入物感染的病例。虽然水平切口技术获得了略高的患者满意度评分，但差异无统计学意义。
倒T形和水平切口技术各有独特的优缺点。我们的研究结果表明，水平切口技术可提高患者满意度并降低并发症发生率。技术的选择应根据患者的个体风险因素、组织质量和偏好进行定制。
